PRISONERS OF RITUAL:
SOME CONTEMPORARY DEVELOPMENTS
IN THE HISTORY OF FEMALE GENITAL MUTILATION

Hanny Lightfoot-Klein

This paper was presented at the Second International Symposium
on Circumcision in San Francisco, April-30 - May 3, 1991

Female genital circumcision is ubiquitous at all levels of society in
many countries of Africa. It is also practiced, more or less sporadically,
in other continents of the world. In Africa alone, along an uninterrupted
belt across the center of the continent and along the length of the Nile,
an estimated 60-90,000,000 women are circumcised.

Female circumcision is an ancient blood ritual that exists in a variety
of severities. Among some peoples, part or all of the clitoris is
cut away. In others, the procedure further includes the ablation
of the small and/or large labia. The most drastic operations are
found along the Horn of Africa, in Northern and central Sudan, Southern
Egypt, Djibouti, Somalia, parts of Kenya and Ethiopia. Here all of
the above surgeries are inflicted. In addition, the skin of the outer
labia is scraped clean of its inner tissue, and is then sewn together over
the wound, so that only a tiny opening, intended to be barely adequate
for passing urine and menstrual fluid, remains. This widely practiced procedure
is called infibulation or Pharaonic circumcision.

While clitoridectomy and excision of the inner labia are found among
Africans with a variety of religious and cultural orientations, infibulation
appears almost exclusively among Islamic peoples. Infibulation is
best described as a regional rather than a religious practice, however,
since it is generally not found in an estimated 80% of the world's Moslems

The medical and psychic consequences of infibulation in particular may
be devastating and lifelong. No accurate statistics on this
are available or perhaps even possible in Sudan, where most of my research
was carried out. This is a region of Africa, which, given its apparently
insurmountable geographic and social features, has so far defied all attempts
at development. Medical estimates of fatalities among girls
subjected to the procedures in that region, however, are quite high, and
vary from 10 to 30 percent. Since cultural prohibitions do not allow
people to speak about dead children, these estimates must suffice.

A high death rate is to be expected, in view of the fact that most circumcisions
are still carried out among a populace without anesthesia or antibiotics,
with rudimentary, unsterile instruments such as razors, scissors or kitchen
knives. The operators are more often than not medically untrained
older women, often with defective eyesight, and the operation is performed
on the earthen floors of huts, under lighting conditions that are inadequate
to any surgical procedure. Even when the operation is carried out
by medically trained midwives or nurses under what passes for sterile conditions
and with the use of local analgesics and antibiotics, it is still exceedingly
hazardous.

As may be expected, the immediate complications most commonly seen are
hemorrhage, shock due to intolerable and prolonged pain, infection, tetanus
and retention of urine due to occlusion. Later complications resulting
from a tight infibulation generally involve difficult and painful urination,
urinary infections resulting from debris collecting behind the infibulation,
a damming up of menstrual blood in virgins, inclusion cysts and fistulae.

At marriage, the infibulation must be torn, stretched or cut open by
the bridegroom, and then prevented from healing shut. This agonizingly
painful procedure may take weeks or even months to complete. Giving
birth is fraught with mortal danger for both the infibulated woman and
her infant, due to the inelasticity of her infibulation scar, which prevents
dilation beyond four of the ten centimeters required to pass the fetal
head. The infibulation must therefore be cut in an anterior direction
and after birth has taken place, it must be resutured.

Frequently seen psychological complications include severe, recurrent
anxiety, depression and a generalized phobic state. These tend to manifest
themselves at various stress points in a woman's life, such as the period
preceding circumcision, at menarche, before and for some time after marriage,
and with the birth of each child. A severely depressed self-image,
lack of confidence, feelings of sexual inadequacy and worthlessness, repressed
rage and anorgasmia have also been observed. (Lightfoot-Klein, 1989, p.60)

While there are quite a few theories on the origins of female sexual
mutilation, no one actually knows when, how or why it began. While
there are theories which argue that female circumcision antedates male
circumcision, one researcher (Davis 1976,p.158) observes that female circumcision,
along with hymenolatry, occurs only in very restricted areas of the world
-- predominantly Semitic, Islamic and Christian countries. She maintains
that the more ancient a custom or belief, the more universally it is found.
Compared to penis mutilation, the couvade, and male circumcision, whose
ubiquity give testimony to the antiquity of those practices, therefore,
the relative spatial restrictiveness of female circumcision argues for
its more recent innovation.

The rationale for female circumcision seems to be consistent in most
African societies, and is based for the most part on myth, an ignorance
of biological and medical facts, and religion. The clitoris is perceived
variously as repulsive, filthy, foul smelling, dangerous to the life of
the emerging newborn, and hazardous to the health and potency of the husband.

As is also the case with male genital mutilation in our own culture,
female genital mutilation is often believed to carry with it a persuasive
array of health benefits. It is believed to make conception and child-bearing
easier, to prevent acutely dreaded malodorous vaginal discharges, prevent
all manner of sickness, vaginal parasites and the contamination of mother's
milk. Circumcision, and specifically infibulation, is believed to
reduce the sexual drive (they do not), and to protect women not only from
aggressive males (they also do not) but from her own rampant sexuality
and irresistible inborn drive toward total promiscuity.

It is believed in the Sudan that the clitoris will grow to the length
of a goose's neck until it dangles between the legs, in rivalry with
the male's penis, if it is not cut. This concept engenders so much
revulsion and anxiety in men that they would not under any circumstances
consider marrying an uncircumcised or "unclean" girl. Since marriage
and childbearing are as yet virtually the only options open to most African
women (aside from prostitution in the urban areas), this leaves them little
choice but to submit to the practice and to impose it on their daughters.
Alternative economic options for women, coupled with a more rational sex
education, might very well begin to open the way to their eventual rejection
of this bloody ritual.

There have been various reports on female circumcision throughout the
ages. The first historical reference to it can be found in the writings
of Herodotus, who reported its existence in ancient Egypt in the 5th century
B.C. He was of the opinion that the custom had originated in Ethiopia
or Egypt, as it was being performed by Ethiopians as well as Phoenicians
and Hittites (Taba, A.H., 1979). A Greek papyrus in the British Museum
dated 163 B.C. mentions circumcisions performed on girls at the age when
they received their dowries. Various authors have shown that female
circumcision was practiced as well by early Romans and Arabs. In
some groups it appears to have been a mark of distinction, in others a
mark of enslavement and subjugation.

From its probable origins in Egypt and the Nile Valley, female circumcision
is thought to have diffused to the Red Sea coastal tribes, along with Arab
traders, and from there into eastern Sudan. (Modawi, S., 1974)

There are various reports on the practice of infibulation by a number
of 18th century travelers, who observed its performance on slave girls
by slave traders along the Nile. (Widstrand, 1965; Cloudsley, 1983)
Niebuhr, the sole survivor of the first European scientific expedition
to Arabia and Egypt reported on female circumcision in 1767. Sir
Richard Burton, the noted British 19th century explorer, lectured extensively
on the subject of sexuality among what he described as primitive Peoples.
He noted that while the intent of the custom was to dampen the female sexual
drive, its effect was often quite the opposite. He came to the conclusion
that excision of the clitoris and labia rendered women more lascivious
but far less easily satisfied. "The moral effect of female circumcision
is peculiar," writes Burton, "while it diminishes the heat of passion,
it increases licentiousness and breeds a debauchery of mind far worse (sic)
than bodily unchastity." (Burton, R., 1954, p.108)

Efforts by Christian missionaries to persuade tribal leaders to abandon
female circumcision met with no visible success anywhere in Africa.
Attempts by British colonial governments in Sudan and Kenya to legislate
the custom out of existence also failed dismally.

Europe, meanwhile, had its own history of controlling women's sexuality
by a variety of means. These need only be noted briefly here.
Female slaves in ancient Rome had rings threaded through their labia to
prevent them from becoming pregnant. Crusaders brought the chastity belt
to Europe during the twelfth century. Until rather recently, clitoridectomy
was the surgical "remedy" for masturbation in Victorian England and even
more recently in the United States. (Assad, N., 1979, p.12), (Wallerstein,
E., 1980, p.173)

The methods used to repress female sexuality throughout history up to
the present have been many, and have extended worldwide. Lerner (1986,
p.139) observes that in ancient Mesopotamia, the Code of Hammurabi marks
the beginning of the institutionalization of the patriarchal family.
From 1250 B.C. on, public veiling and the sexual control of women have
been essential features of patriarchy. Under this code, fathers were
empowered to treat the virginity of their daughters as a family property
asset. This system and others like it also divides women into classes of
"respectable", which is to say conforming, male-protected and chaste women,
and "disreputable" or unprotected, low class and slave women. Those
women who benefited by securing their own safety and, more poignantly,
the safety of their children, or those who strove to benefit, not only
bowed to the system, but became its staunchest advocates.

Similarly, in present-day African patriarchal societies, female circumcision
is carried out on their daughters and granddaughters, by those same women
who have themselves suffered the mutilation in childhood. Moreover, it
is staunchly defended by women as a rite that is absolutely essential to
the physical health and deportment if these girls, and to the social standing
of the family in the community. They tenaciously adhere to these
same practices, even in those countries where they are now forbidden by
law, such as Sudan, Egypt and Kenya.

Olayinka Koso-Thomas' (1987) observation on the current status of the
practices in most regions of Africa is pertinent here. She declares that
"the eradication of female circumcision must.involve the social, religious
and cultural transformation of certain communities, rather than overturning
or uprooting this base by rapid decrees, because the legislative attempts
of the past, which were aimed at prohibiting it, did not succeed."

Efua Graham, of the Women's Action Group in Great Britain views the
prospects for rapid change even more bleakly. Given the poor economic
situation facing many African states in recent times, she says, many legislators
would undoubtedly see female genital mutilation as a non-issue.
She goes on to say that:

"Even the African women in the health profession see it as a non-issue.
We need to educate people at grass root level." (Ogamien, 1988)

Yet among other African intellectuals, some strong voices have been
raised, questioning these ancient blood rituals. Nawal El Saadawi,
an Islamic Egyptian physician whose outspoken pronouncements on matters
of female sexuality have on occasion landed her in prison, is representative
of the best of them. (Saadawi, N.El, 1982, p.225).
I submit here a quote from her writings:

"In the face of all these strange and complicated procedures aimed at
preventing sexual intercourse in women except if controlled by the husband,
it is natural that we should ask ourselves why women in particular were
subjected to such torture and cruel suppression. There seems to be
no doubt that society, as represented by its dominant classes and male
structure, realized at a very early stage that sexual desire in the female
is very powerful, and that women, unless controlled and subjugated by all
sorts of measures, will not submit themselves to the moral, social, legal
and religious constraints related to monogamy. The patriarchal system,
which came into being when society had reached a certain stage of development
and which necessitated the imposition of one husband on the woman, whereas
a man was left free to have several wives, would never have been possible
or have been maintained to this day without the whole range of cruel and
ingenious devices that were used to keep her sexuality in check, and limit
her sexual relations to only one man, who had to be her husband.
This is the reason for the implacable enmity shown by society toward female
sexuality, and the weapons used to resist and subjugate the turbulent force
inherent in it. The slightest leniency manifested in facing this
'potential danger' meant that woman would break out of the prison bars
behind which the marriage confined her, and step over the steely limits
of a monogamous relationship to a forbidden intimacy with another man,
which would inevitably lead to confusion in descendence and inheritance,
since there would be no guarantee that a strange man's child would not
step into the waiting line of successors. Confusion between the children
of the legitimate husband and the outside lover would mean the unavoidable
collapse of the patriarchal family built around the name of the father
alone.

History shows clearly that the father was keen on knowing who his real
children were, solely for the purpose of handing down his landed property
to them. The patriarchal family therefore came into existence mainly
for economic reasons. It was necessary for society simultaneously
to build up a system of moral and religious values, as well as a legal
system capable of protecting and maintaining these economic interests.
In the final analysis we can safely say that female circumcision, the chastity
belt and other savage practices applied to women are basically the result
of economic interests that govern society. The continued existence
of such practices in our society signifies that these economic interests
are still operative. The thousands of dayas, nurses, paramedical
staff and doctors who make money out of female circumcision naturally resist
any change in the values and practices which are a source of gain to them.
In the Sudan there is a veritable army of dayas who earn a livelihood out
of the series of operations performed on women either to excise their external
genital organs, or to alternately narrow and widen the outer aperture according
to whether the woman is marrying, divorcing, remarrying, or having a child."

The Sudanese procedures to which Saadawi makes reference are a relatively
recent innovation into the circumcision mystique, in a country where female
circumcision and infibulation are already at their most brutal and damaging.
It is a practice called 'recircumcision", in which a woman's vagina is
resutured once more to a pinhole opening after the birth of each child
or before remarriage. Upon resuming sexual intercourse with her husband,
it must then be partially cut or torn open once more to permit penile penetration.
Upon giving birth it must be cut still further to allow the expulsion of
the foetus. The reason for this is that a woman's circumcision scar is
too inelastic to allow these events to take place normally, and becomes
progressively more so after each operation. As Assad comments, all
of this creates economic activity and profit for the legion of midwives
and other health professionals who carry out this never-ending series of
procedures, and who also enthusiastically promote them. As a consequence,
the sexual mutilation industry flourishes in Sudan, much as it does in
our own hospitals here in the United States.

The exact origins of the reinfibulation practice are not known, although
one might safely speculate that they have their roots in the Western "vaginal
tuck". At best, it is a bastardization of this extremely common and
popular Western procedure. Its intent appears to be to make the most
of what is left of a woman's genitalia after she has been subjected to
a drastic excision. What lends substance to such a theory is that
reinfibulation originated among such individuals as would be most likely
to have knowledge of the tuck procedure so popular in the Western World.

Reinfibulation first made its appearance among the more traveled urban
educated class in the capital, no more than fifty years ago. It has spread
rapidly from the urban educated to the uneducated, and from the capital
into towns, outposts and villages. Its most fervent advocates are
of course the practitioners. These enthusiastically urge it upon
their anxious clients as a purported means of giving more sexual pleasure
to a husband.

Women in Sudanese culture live with the ever-present fear that their
husbands will divorce them, will take a second, third or fourth wife, or
will consort with prostitutes. All of these cataclysmic possibilities
must be guarded against. They pose horrendously potent threats in
a society where a woman has absolutely no economic recourse, and where
she can not own any property aside from the bride price gold that she wears
on her body. A divorced woman loses tragically not only in status,
property, protection and social life, but must yield her children to her
husband as well. Divorce is ludicrously easy to obtain for any Islamic
male.

It is to avert these disasters that the Sudanese woman submits so willingly
to a procedure that can only create yet more pain and physical havoc for
her. The practice fits perfectly into the established hymenolatry
of the culture, which in Sudan is characterized by the curious concept
of renewable virginity through repeated infibulation. Recircumcision
makes a woman "like a virgin" once more, and this is believed to give the
husband a very unique and special pleasure.

Some women go so far as to have themselves recircumcised periodically
even when they have not given birth. Parenthetically, my most intensive
interviews with educated Sudanese women present considerable evidence that
given the mutilated condition of their genitalia, a severely narrowed introitus
enables the woman herself to experience more pleasurable sexual stimulation.
While knowledge of this phenomenon is no doubt carefully guarded by women
where it concerns the males of the society, it represents an indisputable
added selling point for the practitioners. (Lightfoot-Klein, 1989)
So far, there is no indication that circumcision practices are dying
out to any considerable extent. Quite the contrary. Along with increased
population movements of circumcising peoples, including the migration of
merchants into outposts, and the placement of civil servants into indigenous
areas, the practices have actually spread within recent years. They are
currently spreading still further into areas where female circumcision
has traditionally never been practiced before.

The reasons for this diffusion of the custom also appear to be largely
economic. In the event of an intermarriage between circumcising immigrants
and non-circumcising indigenous peoples, a far more favorable bride price
may be obtained by a girl's family if she is circumcised. Consequently,
these new, socially less advantaged converts to the custom have come to
practice the most extreme and damaging versions of the procedure in an
effort to make their daughters most desirable and optimally marketable.
They proudly refer to these operations as "scraping the girls clean," and
they justify their eager acceptance of this custom in the belief that "this
is the modern and hygienic way that educated people do it." (Lightfoot-Klein,
1989, p.48)

I am aware of only two clear cut reports of exceptions to this lamentable
development. Unfortunately, with such reports it is sometimes difficult
to sort out truth from wishful thinking.

Among the Nigerian Ibo, a considerable decline in the rate of female
circumcision in recent decades has been reported by one researcher.
A study by Megafu found that in 1983 among a sampling of 140 women between
the ages of 36 and 45, 85% were circumcised. By contrast, this percentage
had dwindled to 33% among a sampling of 120 females between the age of
16 and 25. (Megafu, U., 1983) He comments that he is not sure of
the reasons for this change, but speculates that Western influences play
a part.

Ogunmodede, who reports on this same region, maintains on the other
hand, that the custom may be gradually diminishing, but at what seems to
be a far slower rate than in Megafu's study. She reports that in areas
where the procedures are performed on girls of marriageable age, many run
away from their villages in order to avoid being circumcised. A recent
newspaper report from Germany describes a similar flight of adolescents
in Uganda, where female circumcision has only recently been introduced
into some areas. Such escapees are systematically hunted down and
delivered, bound, to their villages, where they are then forced by the
elders to undergo the rite.

In Ethiopia, when the Eritrean People's Liberation Front occupied certain
territories between January 1977 and December 1978, it successfully opposed
female circumcision and forced marriages. These practices have apparently
not returned, even after the EPLF was forced to retreat from some of these
areas. In fact, the EPLF attracted great numbers of young girls seeking
to avoid the knife to its ranks from many other parts of Ethiopia. (Dines,
M., 1980)

Obviously, such resistance to the custom is possible only among peoples
who practice circumcision on adolescents or young women. In Sudan, Somalia,
Egypt and many other African countries, such an option simply does not
exist, since circumcision takes place there in early childhood, quite frequently
before the girl enters school. In fact, there seems to be evidence
that in most of Africa, girls are being circumcised at earlier and earlier
ages. The reasons for this are given by the practitioners: "A young child
is far easier to manage."

Within recent years, due to the increased influx of African immigrants
into Europe, and of late also into the United States, a new problem has
developed. Circumcisions performed in European countries by local
doctors, by members of a girl's family or by midwives imported for this
purpose have come to the attention of legal authorities, and appear to
have become fairly common. In England it was found that Harley Street surgeons
could be relied upon to perform the procedures for the elite at fancy prices.
In Sweden a scandal developed when it was discovered that a Swedish surgeon
was performing the operation in a Swedish hospital under the Swedish socialized
medicine system, at the expense of outraged Swedish taxpayers. (Lightfoot-Klein,
1989, p.45) In France and Italy hemorrhaging girls were brought into emergency
wards after kitchen knife excisions by family members.

It is exceedingly likely that there have been similar instances in the
United States as well, but so far none have been officially documented.

The escalating problem now facing all of these Western countries is
this: Appropriate statutory prohibitions must be enacted, in order to prevent
this extreme form of child abuse from occurring within their borders.

While African intellectuals of both sexes have become acutely aware
that something is intrinsically very wrong indeed with these ancient blood
rituals, and they wish to see them abandoned, they bitterly resent Western
interference in their social and personal affairs. In view of the all too
recent history of the slave trade and colonialism, it is altogether understandable
that their mistrust of Western motives is deep indeed. The only help acceptable
to them in dealing with this problem would be material aid to programs
that are directed by Africans themselves.

In Sudan, while many young intellectuals declare their intent to begin
abolishing the practice by not circumcising their own daughters, a mere
handful has good intentions into action. There is simply too much family
pressure and fear of breaking with tradition. The same scenario has been
reported in Somalia. (Grassivaro Galli and Viviani, 1988)

The older, tradition-ridden generation of women is generally blamed
for this failure to accept change. However, since the intellectual
climate appears to show some small beginnings of a shift, at least among
that handful of the elite that has been exposed to European university
educations, one might reasonably hope for the stirrings of a modest change
within the next decade or two, after the older generation has died out.

Yet will a major change actually take place? And how long will
it take before this happens? Will this as yet only hypothetical innovation
of leaving girls sexually intact filter down to the uneducated and to the
more remote places in Sudan, as the recircumcision practice has done?
Things being what they are, it is difficult to have much faith that a rapid
change for the better is in the wind. In areas of Africa such as
Sudan, where there are few schools, no paved roads, no electricity, no
functioning telephone systems, even less food and water and many, many
far more pressing problems, change, whatever its nature may be, happens
at a maddeningly slow pace, if it happens at all.

In the absence of such horrendous handicaps, in our own technologically
advanced and advantaged country, our own setbacks and frustrations in our
fight to abolish routine male circumcision in the United States, provide
us only with the dimmest concept of the difficulties that must be overcome
in Africa

We can hardly afford to flatter ourselves into believing that our earnest
efforts so far have created a populist movement among the peoples of Africa
to abolish female genital mutilation. As yet, the only evidence of opposition
to the practice comes from a minute, albeit dedicated group of African
health professionals that are working bravely toward abolishing these cruel
and destructive blood rituals. Their highly laudable efforts are
certainly the first, courageous steps in the right direction, and they
deserve our heartfelt support.

As far as those of us, who labor in behalf of this worthy cause in the Western
world are concerned, we must look at the situation realistically and
to recognize that we are very far indeed from having earned any laurels
that we can rest upon. There is a long, hard and weary road
yet ahead of us and the end, at this point, is nowhere in sight.